Irrigation is a commonly used method for cleaning open, contaminated and chronic wounds. During irrigation, sterile irrigation fluids act upon wounds to remove lifeless tissue, bacterial inoculum, blood clots, loose dirt and foreign bodies in the vicinity and in the depths of the wound. The critical parameters of any wound irrigation method are the application of an adapted volume of sterile irrigation fluid to the wound and the use of sufficient pressure that must be applied in a precise pattern of distribution for effectively removing the contaminants.
In this context, a disposable nozzle is known from EP 2 251 142 A1 for insertion into a handpiece, where said nozzle produces a highly focused high-pressure micro water jet for the treatment of wounds. Such a high-pressure micro water jet can be used in particular for cleaning, washing and debriding necrotic, wet, or otherwise poorly healing wounds (e.g. caused by diseases such as ulcers, gangrene, bedsores, abscesses or fistulas). The kinetic impact force of the fluid under pressure is there utilized in order to clean the wound and to debride it. In particular debridement, i.e. the restoration of the wound bed by removing necrotic and fibrinous layers, requires the use of an irrigation fluid jet that is operated with high pressure.
However, the high pressure of the fluid jet does not only lead to the removal of the layer or of the particles from the wound, but inevitably also to an aerosol (fluid mist) around the wound composed of droplets of body fluid and irrigation fluid floating in the air. However, aerosols can also be produced in other ways, for example, during wound treatment by way of plasma or ultrasound. In the event that no protective measures are taken, such aerosols can freely escape into the environment and thus pose a significant hazard to patients and/or the respective health care professional.
The high hazard potential of such aerosols is due to the fact that wounds almost always are colonized by pathogens (such as bacteria, viruses or fungi), whereby also the aerosols being produced during their treatment represent a potentially infectious medium because they are laden with pathogens. Consequently, dangerous cross-infection could in the absence of additional protection measures occur between the patients and the individuals present in the treatment room or the individuals later entering the treatment room or the individuals later using the treatment equipment. In addition, free distribution of the aerosol during wound treatment would lead to contamination in the treatment room, in particular of the treatment table and the surrounding floor surfaces. This in turn results in an increased risk of slipping and thereby the risk of injury to individuals in the treatment room. A further problem is the obstruction of the view onto the treatment area when the freely spreading aerosol e.g. collects on the protective glasses of the attending person.
In view of the aforesaid drawbacks, numerous methods and devices are known from prior art to mitigate or even to entirely prevent contamination of the environment by aerosols produced during wound irrigation.
The most common and easiest way is to place the body part of the patient to be treated under a transparent disposable protective foil which can be suspended with the aid of a respective stand device and spanned in a tent-like manner. The respective health care professional dons a protective coat, protective gloves, a protective mask and protective glasses before he reaches either under the protective foil or in respective hand openings provided in the protective foil for performing wound treatment. The treatment fluid draining during the treatment can be collected by way of compresses and/or a good absorbent wound pad.
Such protective foils, however, offer only inadequate protection for the health care professionals and patients from body and irrigation fluids laden with bacteria, viruses, fungi, parasites and/or other pathogens spraying back. Firstly, such pathogens can naturally enter the environment through the two hand openings. Secondly, it is disadvantageous that the gloved hand still needs to reach into the treatment chamber located under the protective foil and contaminated with aerosol. The pathogens can therefore after termination of the treatment enter the environment via gloves and protective clothing, e.g., at control buttons of treatment devices. Also disadvantageous is that the visibility and the splash protection effect are inversely proportional to each other. The more hermetically the wound is covered by the protective foil, the more obstructed the vision of the attending person onto the wound area and vice versa.
Though protective foils with extensions designed as gloves for an attending person to slip into are known, such integrated solutions are disadvantageous, however, in that forcing the hands into or out from then glove extensions proves to be very difficult. In addition, the drawback remains that the attending person must reach into the aerosol-contaminated treatment chamber. Also pathogens (such as e.g. bacteria) can continue to enter the environment through the glove extensions.
Furthermore, suction/irrigation tips are known from prior art which have a generally funnel-shaped splash shield at the front (distal) end in order to prevent irrigation fluid from splashing rearward (cf. for example, U.S. Pat. No. 5,460,604 A). A drawback of such devices is that the motion performed during wound treatment by the suction/irrigation tip must also be carried out by the splash shield that bears snugly on the patient's skin. This motion can by the patient be perceived as being painful. Once the splash shield is lifted from the skin to eliminate this pain, however, the tightness of the treatment chamber formed under the splash shield is also reduced. Dangerous, highly contagious fluid droplets can thereby escape into the environment despite the splash shield.
In addition, systems are known in which a fluid jet device is combined with a suction device for the extraction of the tissue cells separated or dissolved and/or the irrigation fluid. Such systems, however, are very complex in design since not only fluid supply but also additional extraction (possibly with recirculation of the irrigation fluid) must be present.